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通过患者参与增强神经纤维瘤病临床试验的结果测量:REiNS 的经验教训。

Enhancing Neurofibromatosis Clinical Trial Outcome Measures Through Patient Engagement: Lessons From REiNS.

机构信息

From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD.

出版信息

Neurology. 2021 Aug 17;97(7 Suppl 1):S4-S14. doi: 10.1212/WNL.0000000000012430. Epub 2021 Jul 6.

Abstract

OBJECTIVE

As part of an evaluation of the Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration patient representative program, we surveyed REiNS members to (1) identify facilitators and barriers to involving patient representatives and (2) understand whether and how involving patient representatives affected recommendations for clinical trial outcomes.

METHODS

We administered an anonymous online survey to all REiNS members. Facilitators and barriers to patient representative involvement were solicited using a modified free listing technique; responses were inductively grouped into higher-order categories and ranked based on saliency score (Smith ). Open-ended questions assessed patient representative expectations for engagement, perceived benefits/costs of patient engagement, and patient representative contributions; responses were analyzed using conventional content analysis.

RESULTS

A total of 63/172 (37%) members responded, including 18/30 (60%) patient representatives. Providing sufficient opportunities to meaningfully engage in research tasks and cultivating a respectful, inclusive atmosphere were key facilitators to patient representatives' satisfaction and ability to make an impact. Respondents perceived that patient representatives directly (through their input on research tasks) and indirectly (through effects on other stakeholders' knowledge and communication style) improved the organization's research, leading to selection of more meaningful, relevant, and feasible clinical trial outcome measures. Ongoing challenges to patient engagement include difficulty scheduling meetings and concerns about the level of scientific knowledge patient representatives needed to effectively engage.

CONCLUSIONS

Involving patient representatives in REiNS improved perceived quality of neurofibromatosis clinical trial outcome measures. Negotiating sufficient opportunities to engage, fostering an inclusive atmosphere, and navigating time pressures are key to effective patient engagement.

摘要

目的

作为对神经纤维瘤病和雪旺氏细胞瘤国际合作组织(REiNS)患者代表计划评估的一部分,我们对 REiNS 成员进行了调查,以(1)确定参与患者代表的促进因素和障碍,以及(2)了解参与患者代表是否以及如何影响临床试验结果的建议。

方法

我们向所有 REiNS 成员发放了匿名在线调查。使用改良的自由列表技术征求患者代表参与的促进因素和障碍;根据显著分数(Smith )将答复归纳为更高阶的类别并进行排名。开放式问题评估了患者代表的参与期望、对患者参与的感知收益/成本以及患者代表的贡献;使用常规内容分析对答复进行了分析。

结果

共有 63/172(37%)名成员做出回应,其中 18/30(60%)名是患者代表。为患者代表提供充分的机会,使其能够有意义地参与研究任务,并营造尊重、包容的氛围,是他们满意和能够产生影响的关键促进因素。受访者认为,患者代表直接(通过对研究任务的投入)和间接(通过对其他利益相关者的知识和沟通方式的影响)改善了组织的研究,从而选择了更有意义、更相关和更可行的临床试验结果衡量标准。患者参与的持续挑战包括难以安排会议以及对患者代表有效参与所需的科学知识水平的担忧。

结论

在 REiNS 中,让患者代表参与提高了神经纤维瘤病临床试验结果衡量标准的感知质量。协商充分的参与机会,营造包容的氛围,以及应对时间压力是有效患者参与的关键。

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